<!-- Breadcrums -->
<?php $this->load->view('helpers/breadcrums.php'); ?>
<!-- Breadcrum -->
<div class="container">
	<div id="main">
		<div class="row">
			<div class="span9">
				<div class="w-box-content cnt_a">
					<div class="row-fluid">
						<div class="span12">
							<h1 class="page-header"><?php echo $text_heading; ?></h1>
							<?php if ($error_warning) { ?>
							<div class="alert alert-error"><?php echo $error_warning; ?></div>
							<?php } ?>
							<form class="form-horizontal" method="post"
								action="<?php echo base_url(); ?>member/register"
								enctype="multipart/form-data" id="validate_field_types"><input
								type="hidden" name="action" value="isRegister">
							<fieldset>
							<h3>If you already have an account with us, please login at the <a
								href="<?php echo base_url(); ?>member/login">login page.</a></h3>
							<div class="control-group"><label class="control-label req"
								for="inputTile">Title</label>
							<div class="controls"><select name="title" id="inputTile">
								<option value="">[select]</option>
								<option <?php if($titleM == "Mr.") {echo 'selected="selected"';} ?>
									value="Mr.">Mr.</option>
								<option <?php if($titleM == "Mrs.") {echo 'selected="selected"';} ?>
									value="Mrs.">Mrs.</option>
								<option <?php if($titleM == "Ms.") {echo 'selected="selected"';} ?>
									value="Ms.">Ms.</option>
								<option <?php if($titleM == "Mdm.") {echo 'selected="selected"';} ?>
									value="Mdm.">Mdm.</option>
								<option <?php if($titleM == "Dr.") {echo 'selected="selected"';} ?>
									value="Dr.">Dr.</option>
							</select></div>
							</div>
							<div class="control-group"><label class="control-label"
								for="inputFirstname">First Name</label>
							<div class="controls"><input type="text" id="inputFirstname"
								name="firstname" value="<?php echo $firstname; ?>"
								placeholder="First Name" class="sepH_b"></div>
							</div>
							<div class="control-group"><label class="control-label"
								for="inputLastname">Last Name</label>
							<div class="controls"><input type="text" id="inputLastname"
								name="lastname" value="<?php echo $lastname; ?>"
								placeholder="Last Name"></div>
							</div>
							<div class="control-group"><label class="control-label"
								for="inputMobile">Mobile Phone</label>
							<div class="controls"><select name="mobile_country" class="width100">
								<option value="62"
								<?php if($mobile_country == 62) {echo 'selected="selected"';} ?>>Indonesia
								(+62)</option>
								<option value="0"
								<?php if($mobile_country == 0 && !empty($mobile_country)) {echo 'selected="selected"';} ?>>Other
								(+)</option>
							</select> <input type="text" maxlength="20" id="phone" name="phone"
								value="<?php echo $phone; ?>" placeholder="Mobile Phone"></div>
							</div>
							<div class="control-group"><label class="control-label" for="inputEmail">Email</label>
							<div class="controls"><input type="text" id="inputEmail" name="email"
								value="<?php echo $email; ?>" placeholder="Email"></div>
							</div>
							<div class="control-group"><label class="control-label"
								for="inputPassword">Password</label>
							<div class="controls"><input type="password" id="inputPassword"
								name="password" value="<?php echo $password; ?>" placeholder="Password"
								class="sepH_b"></div>
							</div>
							<div class="control-group"><label class="control-label"
								for="inputConfirmpassword">Confirm Password</label>
							<div class="controls"><input type="password" id="inputConfirmpassword"
								name="confirmpassword" value="<?php echo $confirmpassword; ?>"
								placeholder="Confirm Password" class="sepH_b"></div>
							</div>
							<div class="control-group">
								<label class="control-label"></label>
								<div class="controls">
									<input type="checkbox" name="news_subscription" value="1" checked="checked"> Subscribe to our mailing list. 
								</div>
							</div>
							<div class="control-group">
								<div class="controls">
									<button type="submit" class="btn btn-primary btn-large">Register</button>
								</div>
							</div>
							</fieldset>
							</form>
						</div>
					</div>
				</div>
			</div>
			<div class="sidebar span3"><?php $this->load->view('account.php'); ?></div>
			</div>
	</div>
</div>
